Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the effectiveness, tolerance and safety of simvastatin (MK 733), a new HMG-CoA reductase inhibitor, a 28-week, single blind study with placebo was carried out on 10 patients suffering from primary hypercholesterolaemia. All patients followed the AHA Phase 1 or Phase 2 diet and underwent active treatment for 24 weeks with increasing doses of simvastatin from 10 to 40 mg in a single evening administration. A reduction in plasma levels of total cholesterol (-29%, p less than 0.001 and -41%, p less than 0.001), LDL cholesterol (-35%, p less than 0.001 and -49%, p less than 0.001), VLDL cholesterol (-9%, ns and -38%, ns), Apo-B (-27%, p less than 0.005 and -37%, p less than 0.001), Apo-A2 (-3%, ns and -3%, ns), and triglycerides (+2%, ns and -10%, ns), was obtained in the VIth and XXIVth week. There was also an increase in HDL cholesterol (+4%, ns and +17%, p less than 0.05), HDL2 subfractions (+9%, p less than 0.05 and +36%, p less than 0.05), HDL3 (+3%, ns and +11%, ns) and Apo-A1 (+7%, ns and +4%, ns). In all patients, simvastatin was generally tolerated and there were no clinical, laboratory or ophthalmological side-effects related to the drug. If long-term studies confirm its safety, simvastatin will offer excellent prospects for the prevention of ischaemic cardiopathy.
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PMID:[Effects of simvastatin on plasma levels of lipids, lipoproteins and apolipoproteins in primary hypercholesterolemia]. 269 57

To evaluate the risk factors for coronary disease, 345 women, aged 35 to 59 years, who had undergone coronary arteriography for suspected coronary disease completed a mail questionnaire, telephone interview, or both. Two hundred eight women with angiographically normal coronary arteries constituted the control group, and 137 with a 70% or more occlusion of one or more coronary vessels were classified as having severe coronary occlusive disease. Age-adjusted odds of severe coronary disease based on the logistic regression model for the risk factors evaluated were as follows: smoking, 5.73 (p less than 0.001); diabetes, 5.09 (p less than 0.001); cholesterol level greater than 240 mg/dl, 2.35 (p less than 0.05); a parental history of death from heart disease before age 60 years, 2.03 (p less than 0.05); and estrogen use for 6 months or longer, 0.50 (p less than 0.01). There were no differences with regard to the presence of obesity and a history of hypertension in women with and without coronary disease. These data support the hypothesis that use of noncontraceptive estrogen significantly reduces the risk of severe coronary disease, whereas smoking, an elevated cholesterol level, and a parental history of heart disease all increase the risk of ischemic heart disease in women.
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PMID:Risk factors and noncontraceptive estrogen use in women with and without coronary disease. 272 50

To evaluate the impact of large scale population screening for elevated total cholesterol, a city-wide event was scheduled in Indianapolis during nine days in February 1987. Altogether, 29,954 individuals were screened, and more than 32% were found to be at moderate or high risk using the classification recommended by the National Institutes of Health at the time of the screening for heart disease on the basis of their total plasma cholesterol concentrations. Although larger numbers of females and whites volunteered to be screened, the screened population represented a broad range of age and education levels. Results of a followup questionnaire returned by 18% of those at moderate of high risk revealed that after receipt of an elevated cholesterol result, 67% of the respondents scheduled a physician visit. The majority of those not doing so (53%) contacted their physician for other reasons or by telephone. Results of the followup indicate that screened subjects responded appropriately to the results received. The results of this project indicate that mass screening is only one tool to successfully identify individuals at risk. Given the biases present in the screened population, other strategies should be used to identify at-risk members of population groups unlikely to participate in similar screening events.
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PMID:Indianapolis cholesterol screening 1987: does mass screening accomplish its goal? 275 43

Demand for physician-based dietary treatment of hypercholesterolemia is increasing, but medical care providers feel that they lack the skills and confidence necessary to provide these services. Using a self-administered questionnaire, we studied the relationships among dietary knowledge, attitudes, and behaviors to identify the educational needs of entering medical students. On average, dietary behavior and background knowledge of the diet-coronary heart disease association compared favorably to national dietary recommendations and knowledge of the U.S. public. However, practical knowledge necessary for diet counseling was weak, and attitudes about the "prudent" diet were poor. More favorable attitude scores were associated with healthier eating habits, while greater knowledge was not. Our results suggest that entering medical students already have a basic understanding of the diet-heart disease link, which is covered in the curricula of most medical schools. Medical education should include more emphasis on practical dietary knowledge and improving attitudes about the prudent diet.
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PMID:Medical students' knowledge, attitudes, and behavior concerning diet and heart disease. 278 49

Familial hypercholesterolaemia (FH) is one of the most commonly inherited diseases. It is characterised by an abnormal LDL receptor resulting in a selective elevation of serum LDL and cholesterol levels. The correlation between FH and premature heart disease means that these patients contribute significantly to the number of individuals presenting with coronary heart disease. In the work described here cDNA probes to LDL-receptor were used to assess the usefulness of recombinant DNA technology to diagnose familial hypercholesterolaemia. A 3' probe to the LDL-receptor which detects a restriction fragment length polymorphism (RFLP) in linkage disequilibrium with normal and mutant LDL-receptor genes, was found to be potentially informative in 20% of the families studied. In addition a 5' probe to the LDL-receptor may be capable of directly detecting mutations in some 6% of families. We suggest that until further work has established other RFLP's or oligonucleotide probes are synthesised to directly detect mutant LDL-receptor genes, recombinant DNA technology is only of limited value for diagnosing familial hypercholesterolaemia.
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PMID:Diagnosis of familial hypercholesterolaemia using DNA probes for the low-density lipoprotein (LDL) receptor gene. 289 32

Two national panels have recommended similar, specific strategies for detecting hypercholesterolemia: selective screening for children aged 2 to 19, and mass screening for individuals aged 20 and over. It is, however, unclear how best to apply these recommendations to a college student population. In order to determine which strategy is more efficient, this study compared mass with selective screening of college students for hypercholesterolemia. In the mass screening strategy, all entering students were asked to have their cholesterol levels measured and to provide other coronary risk factor information. In the selective screening strategy, all sophomores with a family history of heart disease were asked to participate in a risk factor screening program. In this study, mass screening identified more hypercholesterolemic students with less effort per case found than did selective screening. We recommend that college health practitioners consider mass screening programs to identify students who could benefit from coronary risk reduction.
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PMID:Screening for hypercholesterolemia in college students. 292 25

We tested the feasibility and effectiveness of population cholesterol screening in a California shopping center. Total plasma cholesterol (TC) was measured in 429 adults from capillary blood samples, using automatic analyzers (Reflotron). A self-administered questionnaire was used to ascertain demographic variables, lifestyle, and knowledge about cholesterol and heart disease. According to NIH Consensus Conference criteria, 20% of all screenees showed moderate or high risk TC levels, but over half of these had a history of hypercholesterolemia prior to testing. Follow-up of all screenees with TC levels at 220 mg/dl and greater revealed that 32% had been compliant with our advice to contact their physician. Physicians expressed no concern in 71% of those with TC elevation of 220-239 mg% and in 30% of those with TC levels 240+ mg%. Of all participants, 40% reported dietary changes in response to the screening; 78% of this group, however, made changes without a physician's advice. In our experience community cholesterol screening is popular and feasible. Efficacy, however, must be improved by better education of physician and the public.
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PMID:A pilot study of community cholesterol screening. 318 61

Large prospective studies and intervention trials have identified major risk factors for premature heart disease in men, while the Framingham Heart Disease Study has provided the leading evidence of predictors of cardiovascular disease in women. We evaluated the role of these risk factors in a 13-year follow-up study of 8935 premenopausal and 2716 postmenopausal women in the Walnut Creek Contraceptive Drug Study cohort in Northern California. Elevated cholesterol levels, high blood pressure, smoking, obesity, family history of heart disease, and diabetes were investigated for their contribution to premature death due to all causes and due to cardiovascular disease. In addition, risk factor profiles were developed separately for users and nonusers of Premarin (conjugated estrogen) in the postmenopausal cohort. The results show that the strongest predictors of cardiovascular mortality among premenopausal women were smoking, high blood pressure, and diabetes, with relative risks of 2.8, 10.5, and 11.6, respectively. A disparity between high cardiovascular risk factor prevalence and low rates of premature heart disease indicates that the high relative risks will not be accompanied by large attributable risks. Nevertheless, the study reconfirms the need for screening women for heart disease risk because life-style changes can improve cardiovascular risk factors and can potentially reduce the chance of premature death even further.
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PMID:Cardiovascular risk factors, premature heart disease, and all-cause mortality in a cohort of northern California women. 337 34

There is now substantial scientific evidence that patients with coronary heart disease (CHD) have a high prevalence of hypercholesterolemia and stand to benefit significantly from efforts to lower cholesterol levels. To evaluate physician practice patterns and attitudes concerning cholesterol assessment and management of patients hospitalized with an admitting diagnosis of CHD, one-month medical record audits were performed during 1983, 1984, and 1985, and a physician survey was administered in early 1986. Medical records of 154 inpatients hospitalized with a diagnosis of CHD before 60 years of age showed that, on the average, 18% had lipid profiles ordered and 11% received a low-fat diet in the hospital. The admission history and follow-up notes mentioned the presence or absence of lipid abnormalities in 53% of CHD inpatients. No significant changes occurred from 1983 to 1985. Survey results from 184 hospital staff physicians caring for these patients showed that less than half believed that a reduction in blood cholesterol lowers risk for heart disease in middle-aged patients with CHD. Interns and residents indicated less confidence in the efficacy of cholesterol-lowering diet and drug therapy than did attending physicians. The implications of these findings for physician training are discussed in light of recent studies of the efficacy of cholesterol lowering in secondary prevention.
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PMID:Cholesterol management in patients hospitalized for coronary heart disease. 339 98

A cross-sectional study of hypercholesterolaemia in a random sample of 976 subjects showed that hypercholesterolaemia was common in a coloured population. Of the males 17.4% and of the females 16.2% had total serum cholesterol values above 6.5 mmol/l. Using a cut-off point of 5.7 mmol/l the age-standardised prevalence of hypercholesterolaemia was 34.5% for males and 32.9% for females. Age- and sex-specific cut-off points showed that 69.2% of males and 65.9% of females were at risk for coronary heart disease (CHD) by virtue of the total cholesterol level. Of the males 19.1% and of the females 13.4% warranted investigation for possible familial hypercholesterolaemia. A protective high-density lipoprotein cholesterol/total cholesterol ratio was found in 61.2% of males and 51.9% of females. Hypercholesterolaemia was statistically significantly associated with a reported history and a familial history of CHD as well as with hypertension and diabetes in some groups studied. Unlike most cross-sectional studies this study showed that hypercholesterolaemic participants consumed more saturated fat and their diets had a higher Keys score than did normocholesterolaemic participants. Only 16.5% of males and 21.7% of females had modified their diets to prevent heart disease. High levels of total cholesterol were found to be associated with high levels of serum triglycerides and uric acid, high body mass index, high diastolic and systolic blood pressure and higher socio-economic standing. An education programme to initiate the dietary modifications that lead to the lowering of serum cholesterol levels is necessary to reduce CHD in the coloured population.
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PMID:Hypercholesterolaemia in the coloured population of the Cape Peninsula (CRISIC study). 349 20


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